Factors affecting hospital readmission and rehospitalization following percutaneous nephrolithotomy.

Abstract

To identify patient- and procedure-related factors that increase the risk of hospital readmission and emergency room (ER) visits after percutaneous nephrolithotomy (PNL). We retrospectively reviewed the records of patients with kidney stones treated via PNL in two tertiary referral hospitals between 2008 and 2014. Patient demographics including age, body mass indices, ASA score, stone size, presence of anatomic abnormality and comorbidity, operative and postoperative measures, and ER visit and rehospitalization rates were reviewed. Unplanned readmission to the hospital, including elective, and ER visits due to any reason related to the PNL procedure were primarily examined. The factors affecting ER visit and rehospitalization rate were analyzed using logistic regression analysis. A total of 1024 patients (mean age 46.57years) were enrolled into the study. Mean stone size was 28.5mm. Stone-free status was achieved in 81.7% of the procedures. Complications occurred at a rate of 6.44% in the postoperative period. ER visit and rehospitalization rates were 5.76 and 5.27%, respectively. While stone complexity, anatomic abnormalities, and postoperative course were found to be factors affecting ER visit, postoperative course and hospitalization time were main predictors for rehospitalization rate. Our outcomes demonstrate that patients, who had an anatomic abnormality and complex kidney stone, were more likely to have an unplanned hospital readmission. Patients with a history of perioperative and/or postoperative complication seem to have a tendency to unplanned readmission and rehospitalization.